What are the methods to eliminate fallopian tube masses?

The health of the fallopian tubes is very important to women. If there are serious problems with the fallopian tubes, it will cause problems with the delivery of eggs in women, and ultimately lead to infertility. Therefore, if a woman has a fallopian tube mass, she must be treated in time. At this time, she should not take medicine at will. It is best to go to the hospital for an authoritative examination and receive scientific treatment under the guidance of a doctor.

First, the treatment of fallopian tube masses

Conservative treatment: Combination of Chinese and Western medicine;

Surgical treatment: hysteroscopy + laparoscopy.

Other treatments for fallopian tube obstruction: tubal hydrotubation. This treatment is still used by most medical institutions, but it has poor efficacy and a high false positive rate.

Conventional surgical treatment: For those who do not respond to conservative treatment, the diseased fallopian tube can be treated with salpingostomy, adhesion separation, fallopian tube anastomosis, hysterosalpingography, etc. Conventional surgery requires large incisions and slow recovery after surgery.

Second, clinical manifestations of fallopian tube obstruction

Generally speaking, there are no typical symptoms. The most common manifestation is infertility. The fallopian tube plays an important role in transporting sperm, absorbing eggs and transporting fertilized eggs to the uterine cavity. Blockage of the fallopian tube hinders the passage of sperm and fertilized eggs, leading to infertility or ectopic pregnancy. If the fallopian tube obstruction is caused by pelvic inflammation, it may be accompanied by lower abdominal pain, back pain, increased secretions, pain during sexual intercourse, etc.

Third, check for fallopian tube obstruction

1. Physical examination

Signs of infection should be checked, cervicitis should be checked, and signs of PID should be carefully checked, including cervical lifting tenderness and adnexal tenderness. Increased vaginal discharge should not be ignored, and cervical secretion culture is a good choice. Patients with signs of endometriosis such as uterine sacral tenderness or nodules should be examined rectally and vaginally. If the patient has had this disease, chlamydial antibody (CAT) testing should be performed. Many studies support the relationship between CAT and fallopian tube disease. Retrospective analysis shows that its sensitivity and specificity are 92% and 70%, respectively.

2. Auxiliary examination

If the patient is at low risk for tubal disease or has no other causes of infertility, HSG is the first choice. If the patient is at higher risk or has the potential for disease, laparoscopic evaluation may be considered. The gold standard for fallopian tube assessment is by laparoscopy and methylene blue dye injection.

(1) The fallopian tube is perfused by injecting methylene blue solution or normal saline solution into the uterine cavity from the cervix, and then flowing from the uterine cavity into the fallopian tube. The resistance during injection and the reflux of the liquid are used to determine whether the fallopian tube is unobstructed. Due to the advantages of simple equipment, easy operation and low price, this method of fallopian tube permeability examination was widely used before the 1980s. However, since the entire process relies on the doctor's subjective feeling and judgment, and the location of the fallopian tube blockage cannot be determined, the tension during the examination can cause fallopian tube spasm and cause false positives. In recent years, surgery can be performed under ultrasound monitoring, which has improved the accuracy rate, but in actual clinical work, it was found that this method has a high misdiagnosis rate, so it is not an ideal examination.

(2) Hysterosalpingography (HSG) was first used in the 1920s. It involves injecting a high-density substance composed of a high atomic number (such as iodine, diatrizoate, etc.) into the uterine cavity through the cervical canal. This creates a clear artificial contrast with the surrounding tissue under X-ray film, allowing the lumen to be visualized. It can detect tubal occlusion, tubal motility, mucosal damage caused by previous infection or tubal endometriosis, hydrosalpinx, isthmus nodules, adhesions, and tubal abnormalities (such as accessory valves and diverticula). It is a fast, economical, and low-risk examination. HSG has a sensitivity of 65% for tubal occlusion and adhesions, but painful tubal spasm can cause false positives, while pain, infection, and contrast agent invasion into the vascular system are rare complications.